AB1082 FREQUENCY AND SEVERITY OF COVID-19 IN PATIENTS WITH VARIOUS RHEUMATIC DISEASES TREATED REGULARLY WITH COLCHICINE OR HYDROXYCHLOROQUINE
Authors: M. Oztas, M. Bektaş, I. Karacan, N. Aliyeva, A. Dag, S. Aghamuradov, S. B. Cevirgen, S. Sari, M. Bolayirli, G. Can, G. Hatemi, E. Seyahi, H. Ozdogan, A. Gul, S. Ugurlu
Journal: Annals of the Rheumatic Diseases (2022)

Background Several anti-inflammatory drugs which were targeted different mechanisms and investigated for both prevention and treatment for COVID-19. Objectives The current study aimed to investigate whether patients regularly using colchicine or hydroxychloroquine (HCQ) have an advantage of protection from COVID-19 or developing less severe disease. Methods Patients who were taking colchicine or HCQ regularly for a rheumatic disease including Familial Mediterranean Fever, Behçet’s syndrome, Systemic Lupus Erythematosus, Rheumatoid Arthritis and Sjogren’s syndrome as well as their healthy household contacts as the control group were included into the study. The clinical data regarding COVID-19 were collected using a standard form, and serum samples were analyzed for anti-SARS-COV-2 nucleocapsid IgG. Patients treated with any biologic or immunosuppressive treatments were not included into the study. Results A total of 635 regular colchicine users with their 643 household contacts and 317 regular HCQ users with their 333 household contacts were analyzed. Anti-SARS-Cov2 IgG was positive in 43 (6.8%) regular colchicine users and 35 (5.4%) household contacts (OR=1.3; 95% CI:0.8-2; p=0.3) (Table 1). COVID-19 related symptoms were described by 29 (67.4%) of the patients and 17 (48.6%) household contacts (OR=2.2; 95% CI:0.9-5.5; p=0.09), and hospital admission was observed in five (11.6%) and one (2.9%) of these subjects (OR=4.5; 95% CI:0.5-40.2; p=0.1), respectively (Figure 1). Seropositive subjects were observed in 22 (6.9%) regular HCQ users and 24 (7.2%) household contacts (OR=1.1; CI:0.6-1.9; p=0.8) (Table 1). COVID-19-related symptoms occurred in 16 (72.7%) of the 22 patients and 12 (50%) of 24 household contacts (OR=2.7; 95% CI:0.8-9.1; p=0.1). Three patients (13.6%) were admitted to hospital, while one household contact (4.2%) was hospitalized (OR=3.6; 95% CI:0.3- 37.8; p=0.2) (Figure 1). Disease-specific analyses disclosed that there was no significant difference in terms of COVID-19 frequency and severity between a particular disease subset and household contacts (Table 1). Univariate logistic regression analysis showed no effect of age and gender on the SARS-CoV-2 seroprevalence rate among regular colchicine or HCQ users and household contacts (p=0.2 and p=0.7, respectively for colchicine users versus contacts, p=0.7 and p=0.3, respectively for HCQ users versus contacts). Figure 1. Severity of COVID-19 in regular colchicine or HCQ users and these patients’ household contacts Table 1. Disease specific outcomes of the entire cohort Variable FMF (n=373) FMF HHC* (n=386) P Behcet Patients (n=262) Behcet HHC (N=257) P SLE Patients (N=197) SLE HH (n=221) p RA Patients (n=79) RA HH (n=73) P Sjögren patients (N=41) Sjögren HH (N=39) p Age, mean ± SD years 36.4 ± 13.2 36.3 ± 16.1 0.9 42.9 ± 11.4 38.1 ± 15.2 0.001 44.2 ± 12.6 39.4 ± 17 0.002 53.9 ± 10.3 40.3 ± 16.6 0.001 57.1 ± 11.2 46.2 ± 16.1 0.001 Gender, n (%) Female 249 (66.8) 173 (44.8) 0.001 160 (61.1) 118 (45.9) 0.001 184 (93.4) 75 (33.9) 0.001 73 (61.1) 20 (27.4) 0.001 41 (100) 10 (25.1) 0.001 Positive antibody to SARS-COV-2, n (%) 25 (6.7) 23 (5.9) 0.6 18 (6.9) 12 (4.7) 0.3 14 (7.1) 19 (8.6) 0.6 4 (5.1) 2 (2.7) 0.5 4 (9.8) 3 (7.7) 0.9 Symptomatic COVID-19 in seropositive cases, n (%) 18 (72) 10 (43.4) 0.04 11 (61.1) 7 (58.3) 0.6 11 (78.6) 9 (47.3) 0.07 3 (75) 0 (0) 0.4 2 (50) 3 (100) 0.4 Hospital admission in seropositive cases, n (%) 1 (3.8) 0 (0) - 4 (22.2) 1 (8.3) 0.3 2 (14.3) 0 (0) 0.2 1 (25) 0 (0) - 1 (25) 1 (33.3) 0.3 Mean colchicine dose, mg/day ± SD 1.5 ± 0.4 - - 1.4 ±0.4 - - - - - - - - - - - Mean duration of colchicine usage, years ± SD 11.3 ± 8.3 - - 10.4 ± 7.7 - - - - - - - - - - - Mean HCQ dose, mg/day ± SD - - - - - - 263.6 ± 95.1 - - 255 ± 90.8 - - 273.7 ± 132.5 - - Mean duration of HCQ usage, years ± SD - - - - - - 10.1 ± 6.6 - - 7.3 ± 5.2 - - 9 ± 6.3 - - HCQ hydroxychloroquine , FMF familial mediterranean fever, HHC household contacts, RA rheumatoid arthritis, SLE systemic lupus erythematosus Conclusion Being on a regular treatment of colchicine or HCQ was not resulted in the prevention of COVID-19 or amelioration of its manifestations. Disclosure of Interests None declared